Acta clinica Croatica, Vol. 65. No. 2, 2026.
Case report
https://doi.org/10.20471/acc.2026.65.02.19
Acute Severe Euvolemic Hyponatremia Caused by Segmental Pulmonary Thromboembolism and Complicated by COVID-19 Infection: A Case Report
Bojan Mitrović
; Department of Endocrinology and Diabetes, Zemun Clinical Hospital, Belgrade, Serbia; Medicine Intensive Care Unit, Zemun Clinical Hospital, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
Milan Obradović
; Department of Radiobiology and Molecular Genetics, Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
*
Esma R. Isenović
; Department of Radiobiology and Molecular Genetics, Vinča Institute of Nuclear Sciences, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
Zoran Gluvić
; Department of Endocrinology and Diabetes, Zemun Clinical Hospital, Belgrade, Serbia; Medicine Intensive Care Unit, Zemun Clinical Hospital, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
Milena Lacković
; Department of Endocrinology and Diabetes, Zemun Clinical Hospital, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
Sandra Pekić Djurdjević
; Department of Endocrinology, Diabetes and Metabolic Diseases, Division of Neuroendocrinology, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
Milan Petakov
; Department of Endocrinology, Diabetes and Metabolic Diseases, Division of Neuroendocrinology, Clinical Center of Serbia, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
* Corresponding author.
Abstract
Hyponatremia is frequently encountered in clinical practice. Euvolemic hyponatremia
(syndrome of inadequate antidiuresis, SIAD) represents diagnostic
and management challenges regarding etiology unraveling, gradual acute
substitution, and later causal treatment. Here we present a case of severe
SIAD caused by segmental pulmonary thromboembolism and manifested as
acute psychosis. COVID-19 complicated the course of the disease acquired
in hospital settings. By simultaneous treatment of pulmonary thromboembolism,
gradual substitution of hyponatremia, and treatment of COVID-19, the
patient completely recovered biochemically and mentally. Even experienced
clinicians are confused about diverse clinical manifestation of SIAD. Attentive
correction of hyponatremia and treatment of its etiology are the mainstays
of SIAD management.
Keywords
Hyponatremia; Hypertonic saline; Pulmonary thromboembolism
Hrčak ID:
347734
URI
Publication date:
10.6.2026.
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